2017-2018 SkillsUSA Arizona Statement of Assurance

Every Advisor must complete this form and submit it to SkillsUSA Arizona. This form is only completed once per school year and verifies that each attending student has completed the Liability & Medical Release Form. The SkillsUSA Arizona staff will verify receipt of this form prior to accepting registration to any conference, event, activity or meeting that involves students. Advisors: Keep your students Liability & Medical Release form on-hand at each conference. Do NOT send copies to the SkillsUSA office.

Chapter Name
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Other (New School Name)

Section Name
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Please enter section (program) name

Advisor Name
*FirstLast

Advisor Email
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A copy of assurance will be emailed to this address

Advisor Cell Phone
*###-###-####

Agreement and Compliance

By checking the box, I agree that I have obtained a completed and signed Personal Liability & Medical Release Form for each student attending any of the following SkillsUSA Arizona activities or any other workshops, seminars, and activities sponsored by SkillsUSA Arizona and/or national SkillsUSA, Inc.: , Washington Leadership Training Institute (WLTI), Leadership Training Conference (FLC), SkillsUSA on Ice, Leadership Training Camp (LTC), Regional SkillsUSA Conferences (RSC), SkillsUSA Arizona Championships, SkillsUSA Championships & NLSC, Any SkillsUSA Arizona endorsed, sponsored or hosted activity, function, conference or meeting.

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Accept

Possession of Student Forms

By checking the box, I am also indicating that I will have the SkillsUSA Arizona Personal Liability & Medical Release Forms in my possession for the duration of any of the above activities, including travel to and from these activities. I also understand the following: 1. SkillsUSA Arizona will not collect the Liability & Medical Release Forms prior to or at SkillsUSA activities. 2. A copy of this "Statement of Assurance" form should be on file at the SkillsUSA Arizona office prior to attending a conference. Advisors should take the original copies of the students' Personal Liability & Medical Release Forms with them to each event. 3. The SkillsUSA Arizona Personal Liability & Medical Release Forms, when properly and totally completed, represents my student's and my best liability and medical protection during SkillsUSA activities.

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Accept

Membership

By checking the box, I understand that all contestants at the SkillsUSA Arizona Championships must be members of SkillsUSA by the March 1 deadline. No exceptions will be made. I understand membership must be submitted in addition to conference registration. Registration for any SkillsUSA conference does not automatically submit membership for a participant.

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Accept

Complete Compliance

By entering my name below, I certify that I have read the above and hereby offer assurance that I understand and agree to comply with and enforce the policies stated.